BACKGROUND/OBJECTIVES: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). METHODS: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. RESULTS: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65-0.80 and 0.61-0.75, respectively, p < 0.001 for both). CONCLUSION: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

The SARS-CoV-2 pandemic has almost 56 million confirmed cases resulting in over 1.3 million deaths as of November 2020. This infection has proved more deadly to older adults (those >65 years of age) and those with immunocompromising conditions. The worldwide population aged 65 years and older is increasing, and the total number of aged individuals will outnumber those younger than 65 years by the year 2050. Aging is associated with a decline in immune function and chronic activation of inflammation that contributes to enhanced viral susceptibility and reduced responses to vaccination. Here we briefly review the pathogenicity of the virus, epidemiology and clinical response, and the underlying mechanisms of human aging in improving vaccination. We review current methods to improve vaccination in the older adults using novel vaccine platforms and adjuvant systems. We conclude by summarizing the existing clinical trials for a SARS-CoV-2 vaccine and discussing how to address the unique challenges for vaccine development presented with an aging immune system.

Before the COVID-19 pandemic it was widely reported that, in the United States, over 40 percent of food produced was wasted During the pandemic, news reports have described unprecedented household food waste, up by 30 percent according to Republic Services, one of the largest waste management services in the US (Helmer 2020) But upstream, food waste was, and continues to be, equally problematic When institutions such as schools and universities, large businesses, restaurants, and other venues must shut down, so too must the food supply chain for those locations Farmers who produce food for large-scale public use have been unable to redirect their products for grocery markets, and so in many cases their harvests and dairy cannot be used Elsewhere along the chain, farm and other food laborers (e g , meat-packing workers, delivery workers) without access to protection and health care cannot continue to pack and deliver food at "normal" levels, and so potential food has been left in fields and warehouses (Evich 2020)

Multidrug-resistant Klebsiella pneumoniae (MDR-KP) is a major public health problem that is globally associated with disease outbreaks and high mortality rates. As the world seeks solutions to such pathogens, global and regional surveillance is required. The aim of the present study was to examine the antimicrobial susceptibility pattern and clonal relatedness of Klebsiella pneumoniae isolates collected for a period of three years through pulse field gel electrophoresis (PFGE). Isolate IDs, antimicrobial assays, ESBL-production, and minimum inhibitory concentrations (MICs) were examined with the Vitek 2 Compact Automated System. IDs were confirmed by 16S rRNA gene sequencing, with the resulting sequences being deposited in NCBI databases. DNA was extracted and resistance genes were detected by PCR amplification with appropriate primers. Isolates were extensive (31%) and multidrug-resistant (65%). Pulsotype clusters grouped the isolates into 22 band profiles that showed no specific pattern with phenotypes. Of the isolates, 98% were ESBL-KP, 69% were carbapenem-resistant Enterobacteriaceae (CRE) strains, and 72.5% comprised the carriage of two MBLs (SIM and IMP). Integrons (ISAba1, ISAba2, and IS18) were detected in 69% of the MDR-KP. Additionally, OXA-23 was detected in 67% of the isolates. This study therefore demonstrates clonal diversity among clinical K. pneumoniae, confirming that this bacterium has access to an enormous pool of genes that confer high resistance-developing potential.

Individuals with substance use disorders exhibit risk-taking behaviors, potentially leading to negative consequences and difficulty maintaining recovery. Non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have yielded mixed effects on risk-taking among healthy controls. Given the importance of risk-taking behaviors among substance-using samples, this study aimed to examine the effects of tDCS on risk-taking among a sample of adults using cannabis. Using a double-blind design, 27 cannabis users [M(SD) age = 32.48 (1.99), 41% female] were randomized, receiving one session of active or sham tDCS over the bilateral dorsolateral prefrontal cortex (dlPFC). Stimulation parameters closely followed prior studies with anodal right dlPFC and cathodal left dlPFC stimulation. Risk-takingassessed via a modified Cambridge Gambling Taskwas measured before and during tDCS. Delay and probability discounting tasks were assessed before and after stimulation. No significant effects of stimulation on risk-taking behavior were found. However, participants chose the less risky option 86% of the trials before stimulation which potentially contributed to ceiling effects. These results contradict one prior study showing increased risk-taking among cannabis users following tDCS. There was a significant increase in delay discounting of a $1000 delayed reward during stimulation for the sham group only, but no significant effects for probability discounting. The current study adds to conflicting and inconclusive literature on tDCS and cognition among substance-using samples. In conclusion, results suggest the ineffectiveness of single session dlPFC tDCS using an established stimulation protocol on risk-taking, although ceiling effects at baseline may have also prevented behavior change following tDCS.

IMPACT: The Wake Forest School of Medicine Mentor Academy has adapted to provide continued effective and relevant formal mentoring training to translational researchers in a virtual format, to improve mentoring and provide effective mentor-mentee communication tools. OBJECTIVES/GOALS: To determine whether the WFSM Mentor Academy (MA), an effective long-standing mentoring program for research faculty, is compromised after moving from an in-person to an online format as a result of COVID-19 restrictions. METHODS/STUDY POPULATION: A vetted National Research Mentoring Network (NMRN) implemented at WFSM addresses 6 major competencies (Effective Communication, Aligning Expectations, Assessing Understanding, Addressing Equity/Inclusion, Fostering Independence, Promoting Professional Development) over 6 months with 10 sessions (20 contact hrs). COVID-19 required that the MA (13 participants) move to an online format after 3 (out of 10) in-person sessions. We survey 26 self-rated mentoring competencies pre- and post MA, based on a numerical 7-point scale ( published for ACTS 2020) and, in 2020, included additional assessments of online versus in-person MA satisfaction/effectiveness and perceived impact on abilities of MA participants to mentor in an exclusively virtual format. RESULTS/ANTICIPATED RESULTS: All 13 participants responded to the survey and rated the online format as effective (9) or somewhat effective (4) for learning content. However, for participant interactions, only 4 found it effective and 9 somewhat effective. When assessing ability to mentor in a virtual format, most negatively affected competencies were helping your mentee network effectively (7 of 13), motivating your mentee (7), and identifying and accommodating different communication styles (6). Goal setting (research goals, career goals) was rated easier under COVID-19 restrictions by 3 mentors. Increases in Pre-Post self-expressed mentoring effectiveness (+1 pt quality;+1 pt meeting mentee expectations) are similar to historical values, and 12 of the 13 mentors changed mentoring practices based on MA experiences. DISCUSSION/SIGNIFICANCE OF FINDINGS: While 2020 ratings for increased effectiveness are similar to prior years, since the 2021 MA will remain online, we will adjust content to address challenges identified in training mentors and in mentoring trainees in virtual settings by strategies to keep MA participants engaged online and sharing new resources for virtual/hybrid format mentoring.

The study aims to verify the predictive power of anxiety, depression, and stress over panic buying, and to assess gender differences. Data was collected in Brazil during May 2020 through an online questionnaire which was composed of sociodemographic questions, the Panic Buying Scale (PBS), the General Health Questionnaire (GHQ-12) to assess anxiety and depression, and the Perceived Stress Scale (PSS-10) to assess stress. 2297 Brazilians (520 men and 1777 women) aged between 18 and 85 years (M = 39.18 years; SD = 14.10 years) answered the questionnaire. Women reported statistically significant higher means' values for anxiety, depression, and stress than men. Though men reported higher panic buying levels than women, the difference was not statistically significant. The regression models revealed that anxiety and stress were panic buying predictors. Comparing gender, the regression models showed that mental health variables (anxiety and stress) explained a higher variance of men's panic buying values than women's values. Hence, there is a significant moderator gender effect between mental health variables and panic buying, as they explained more of the variance of panic buying for men than for women. Psychological support should be provided to individuals, and they should be alerted and educated to the potentially prejudicial outcomes of this type of consumer behavior. Further studies should investigate antecedents and consequences of panic buying.

Inconsistencies are evident in definitions and interpretations of theory, application of theory, and reporting of theory use within the behaviour change field impeding cumulative knowledge advancement. Standardised frameworks and methods are needed to support the definition, application, and reporting of theory, and to assist researchers in understanding how theory should be applied to build cumulative knowledge over time. Progress is being made with the development of ontologies, taxonomies, methods for mapping interventions, and coding schemes; however, consolidation is needed to improve levels and quality of theory use, and to facilitate the translation of theory-driven research in practice. This paper discusses the importance of rigorous theory application and reporting in health-related behaviour change research and outlines the need for a standardised framework that supports both researchers and practitioners in designing, implementing, and evaluating theory-driven interventions in a concrete and consistent manner. To this end, several recommendations are provided to facilitate the development of a standardised framework that supports theory application and reporting in the behaviour change field. Concrete and consistent theory application and reporting will permit critical appraisal within and across studies, thereby advancing cumulative knowledge of behaviour change over time.

While education still faces huge challenges, including the rapid shift to online learning, teaching and assessment, there may be some light at the end of the tunnel, writes Tom Crick MBE FBCS, Professor of Digital Education & Policy at Swansea University.

Background: Optic neuritis (ON) is a cardinal manifestation of multiple sclerosis (MS), aquaporin-4 (AQP4)-IgG-, and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease. However, the prevalence of AQP4-IgG seropositivity and MOG-IgG seropositivity in isolated ON is unclear, and studies comparing visual outcomes and optical coherence tomography (OCT)-derived structural retinal measures between MS-ON, AQP4-ON, and MOG-ON eyes are limited by small sample sizes. Objectives: (1) To assess the prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON; (2) to compare visual outcomes and OCT measures between AQP4-ON, MOG-ON, and MS-ON eyes. Methods: In this systematic review and meta-analysis, a total of 65 eligible studies were identified by PubMed search. Statistical analyses were performed with random effects models. Results: In adults with isolated ON, AQP4-IgG seroprevalence was 4% in non-Asian and 27% in Asian populations, whereas MOG-IgG seroprevalence was 8 and 20%, respectively. In children, AQP4-IgG seroprevalence was 0.4% in non-Asian and 15% in Asian populations, whereas MOG-IgG seroprevalence was 47 and 31%, respectively. AQP4-ON eyes had lower peri-papillary retinal nerve fiber layer (pRNFL; -11.7 m, 95% CI: -15.2 to -8.3 m) and macular ganglion cell + inner plexiform layer (GCIPL; -9.0 m, 95% CI: -12.5 to -5.4 m) thicknesses compared with MS-ON eyes. Similarly, pRNFL (-11.2 m, 95% CI: -21.5 to -0.9 m) and GCIPL (-6.1 m, 95% CI: -10.8 to -1.3 m) thicknesses were lower in MOG-ON compared to MS-ON eyes, but did not differ between AQP4-ON and MOG-ON eyes (pRNFL: -1.9 m, 95% CI: -9.1 to 5.4 m; GCIPL: -2.6 m, 95% CI: -8.9 to 3.8 m). Visual outcomes were worse in AQP4-ON compared to both MOG-ON (mean logMAR difference: 0.60, 95% CI: 0.39 to 0.81) and MS-ON eyes (mean logMAR difference: 0.68, 95% CI: 0.40 to 0.96) but were similar in MOG-ON and MS-ON eyes (mean logMAR difference: 0.04, 95% CI: -0.05 to 0.14). Conclusions: AQP4-IgG- and MOG-IgG-associated disease are important diagnostic considerations in adults presenting with isolated ON, especially in Asian populations. Furthermore, MOG-IgG seroprevalence is especially high in pediatric isolated ON, in both non-Asian and Asian populations. Despite a similar severity of GCIPL and pRNFL thinning in AQP4-ON and MOG-ON, AQP4-ON is associated with markedly worse visual outcomes.

AIM: To explore the mediating role of post-traumatic growth and perceived professional benefits between resilience and intent to stay among Chinese nurses to support Wuhan in managing COVID-19. DESIGN: A cross-sectional questionnaire survey. METHODS: In May 2020, the study recruited a convenience sample of 200 Chinese nurses to support Wuhan in managing COVID-19. A set of self-rating questionnaires was used to measure resilience, post-traumatic growth, perceived professional benefits and intent to stay. Structural equation modelling was performed with 5,000 bootstrap samples using AMOS 23.0. RESULTS: The final model provided a good fit for the data. Resilience had the strongest direct effect on intent to stay. Perceived professional benefits partially mediated the association between resilience and intent to stay. Overall, the serial multiple mediations of post-traumatic growth and perceived professional benefits in the relationship between resilience and intent to stay was statistically significant.

Cardiac amyloidosis (CA) is a restrictive cardiomyopathy with a traditionally poor prognosis. Until recently, CA treatment options were limited and consisted predominantly of managing symptoms and disease-related complications. However, the last decade has seen significant advances in disease-modifying therapies, increased awareness of CA, and improved diagnostic methods resulting in earlier diagnoses. In this review, we provide an overview of current and experimental treatments for the predominant types of CA: transthyretin cardiac amyloidosis (ATTR-CA) and immunoglobulin light chain (AL)-mediated CA (AL-CA). The mainstay of AL-CA treatment is proteasome inhibitor-based chemotherapy with daratumumab and, when feasible, autologous stem cell transplantation. For ATTR-CA, the stabilizer tafamidis is the only US Food and Drug Administration (FDA)-approved treatment. However, promising novel therapies on the horizon target various points in the ATTR-CA amyloidogenic cascade. These include transthyretin gene (TTR) silencing agents to prevent TTR formation, TTR tetramer stabilization and inhibition of oligomer aggregation to prevent fibril formation, anti-TTR fiber antibodies, and amyloid degradation. For end-stage CA, advanced interventions may need to be considered, including heart, heart-kidney, and, for hereditary ATTR-CA, heart-liver transplantation. Despite the evolution of treatment options, CA management remains complex due to patient frailty and therapeutic side effects or intolerance with advanced cardiac disease. This is particularly relevant for those with AL-CA, when active teamwork between the hematologist-oncologist and the cardiologist is critical for treatment success. Often, referral to an expert center is necessary for timely diagnosis, initiation of treatment, and participation in clinical trials.

Objective: To study clinical profile, maternal and fetal outcome in covid positive pregnancies. Methods: A retrospective observational study was done at Lalla Ded hospital, Kashmir, a tertiary care centre. 70 covid positive pregnant women who were admitted from May 2020 to January 2021 were included in the study. Results: The incidence of Covid positive patients in our study was 11.47%. 60% of patients in our study belonged to 26-30 years age group. 50% patients were primigravida, 20% were second gravida. Among the study population, 31(44.3%) patients were term while 22 (31.4%) were preterm. Most patients were asymptomatic (61.4%). Among symptomatic patients, maximum had fever (17.1%) followed by cough (10%) and shortness of breath (4.3%). Associated comorbidity was seen in 33 patients (47.1%). Hypertensive disorders of pregnancy were seen in majority i.e.15.7%, followed by anaemia (11.4%), GDM (8.5%) and hypothyroidism (7.1%). Out of total study population of 70, emergency caesarean delivery (LSCS) was done in 29 patients (41.5%). 21 patients delivered vaginally (30%). Two post-LSCS patients were shifted to designated Covid Intensive care unit (ICU). One patient from the study group died. There were total of 50 deliveries, 10 babies had Neonatal ICU admission (20%), Low birth weight in 9 (18%). Low APGAR score was in 6 (12%). There were 2 stillbirths in the study population. Conclusion: Covid presents as milder disease in pregnancy, but it may be severe in those with associated comorbidities. More studies on susceptibility of pregnant women to infection by Covid-19 are required ? 2021,Online Journal of Health and Allied Sciences.All Rights Reserved

Caseworkers are trained to write detailed narratives about families in Child-Welfare (CW) which informs collaborative high-stakes decision-making. Unlike other administrative data, these narratives offer a more credible source of information with respect to workers' interactions with families as well as underscore the role of systemic factors in decision-making. SIGCHI researchers have emphasized the need to understand human discretion at the street-level to be able to design human-centered algorithms for the public sector. In this study, we conducted computational text analysis of casenotes at a child-welfare agency in the midwestern United States and highlight patterns of invisible street-level discretionary work and latent power structures that have direct implications for algorithm design. Casenotes offer a unique lens for policymakers and CW leadership towards understanding the experiences of on-the-ground caseworkers. As a result of this study, we highlight how street-level discretionary work needs to be supported by sociotechnical systems developed through worker-centered design. This study offers the first computational inspection of casenotes and introduces them to the SIGCHI community as a critical data source for studying complex sociotechnical systems.

This study was to explore the performance of immune function and compositions of hospitalization cost for patients with COVID-19 as well as the application of a grey relational mathematical model (GRMM). A total of 100 COVID-19 patients diagnosed by nucleic acid test and chest CT examination in our hospital were collected in this study. They were divided into 2 groups: non-severe group (mild and moderate patients, n = 57 cases), and severe group (severe and critical patients, n = 43 cases) based on the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) published by the World Health Organization (WHO). The general clinical data, blood routine indexes, cellular immune and humoral immune function test indexes, and the composition of hospitalization costs of the two groups of patients were collected and analyzed. The results showed that the average age, proportion of males, smoking history, and the number and proportion of patients in the non-severe group were smaller than those in the severe group (P < 0.05); the severe group had significantly more shortness of breath patients than the non-severe group (P < 0.05). Compared with the non-severe group, the number of white blood cells (WBC), the number and proportion of neutrophils, and the count of neutrophils/lymphocytes in the severe group increased obviously (P < 0.05), and the number of lymphocytes and the proportion of monocytes decreased dramatically (P < 0.05); the number and proportion of CD3+, CD4+, CD8+, and CD19+ in the severe group were much lower in contrast to those in the non-severe group (P < 0.05), while the ratio of CD4+/CD8+ was greatly higher in contrast to that of non-severe patients (P < 0.05). Compared with the non-severe group, the bed fee, laboratory test fee, diagnosis fee, and medicine fee of the severe group were increased observably (P < 0.05). The changes in hospitalization cost of patients in the severe group was related to bed fees, laboratory fees, and expenses of proprietary Chinese medicines, while the hospitalization cost of patients in the severe group was related to bed fees, laboratory fees, and examination fees. The results revealed that elderly COVID-19 patients with basic diseases were prone to develop severe disease, immune cell depletion may be one of the reasons for the development of severe patients, and the medical insurance policy greatly reduced the hospitalization costs of COVID-19 patients.

The COVID-19 pandemic has caused a drop-in economic activity and energy consumption of the United States. This work aims to investigate the spillover effects of the United States COVID-19 economic recession on economic growth and energy consumption in other nations using a global vector autoregressive (GVAR) approach and quarterly data between 1990 and 2013 from 41 major countries/regions. On the one hand, the simulation results indicate that the US COVID-19 recession has a negative impact on other countries economic growth through trade ties, reducing the economic growth of other countries, especially for countries which have a close trade relationship with the US. In addition, the spillover effects of the US economic recession have different impacts on other countries energy consumption. Countries with the closest trade ties to the US are most affected, such as Japan and China. In addition, the impact of the US economic shock on energy consumption in developing countries is significant in the short term, while its impact on developed countries is significant in the long term. On the other hand, the simulation results of energy spillover effects indicate a reduction in US energy consumption slightly reduces economic growth in other nations. In addition, a reduction in energy consumption in the US does not have a significant negative impact on energy consumption in other developed countries. Furthermore, the spillover effect of declining energy consumption in the US on energy consumption in developing countries is significant in the short term. However, the spillover effects of falling energy consumption in the US on developing countries are different. The spillover effect of the decline in energy consumption in the US causes a slight decline in energy consumption in China and Brazil, whereas the spillover effect of the decline in energy consumption in the US does not cause a decline in energy consumption in India and Brazil.

Tiny plastic particles considered as emerging contaminants have attracted considerable interest in the last few years. Mechanical abrasion, photochemical oxidation and biological degradation of larger plastic debris result in the formation of microplastics (MPs, 1 m to 5 mm) and nanoplastics (NPs, 1 nm to 1000 nm). Compared with MPs, the environmental fate, ecosystem toxicity and potential risks associated with NPs have so far been less explored. This review provides a state-of-the-art overview of current research on NPs with focus on currently less-investigated fields, such as the environmental fate in agroecosystems, migration in porous media, weathering, and toxic effects on plants. The co-transport of NPs with organic contaminants and heavy metals threaten human health and ecosystems. Furthermore, NPs may serve as a novel habitat for microbial colonization, and may act as carriers for pathogens (i.e., bacteria and viruses). An integrated framework is proposed to better understand the interrelationships between NPs, ecosystems and the human society. In order to fully understand the sources and sinks of NPs, more studies should focus on the total environment, including freshwater, ocean, groundwater, soil and air, and more attempts should be made to explore the aging and aggregation of NPs in environmentally relevant conditions. Considering the fact that naturally-weathered plastic debris may have distinct physicochemical characteristics, future studies should explore the environmental behavior of naturally-aged NPs rather than synthetic polystyrene nanobeads.

Based on a review of the medical literature, the authors document the key points regarding the tests available in France to screen for and diagnose of CoV-2 infestation.

COVID-19 is a novel disease best known to cause a cough, fever and respiratory failure. Recently, it has been recognised that COVID-19 may present in multi-systemic ways which can cause diagnostic uncertainty or error. We present a patient who attended hospital with features of Guillain-Barr syndrome (GBS) before developing clinical and radiological findings of COVID-19. While the authors recognise that neurological complications have been reported following COVID-19 infection, to their knowledge this report describes a unique presentation of GBS without preceding COVID-19 symptoms. Since these conditions may have considerable overlapping features including respiratory failure and (following prolonged critical care admission) profound weakness, it is possible that one diagnosis may be overlooked. Raising awareness of a possible association between these conditions is important so both are considered allowing appropriate investigations to be arranged to optimise the chance of neurological recovery and survival, while also protecting staff from potentially unrecognised COVID-19.

Epidemiologic methods were applied in an investigation into causes of neonatal mortality on a 1400-cow dairy in the southern San Joaquin Valley of California. A format for collation of information on birthdate and date of death was assembled into a matrix which improved conceptualization of the data and which simplified procedures for estimation of mortality rates. Contemporary and birth cohort life table methods, mortality density estimations and relative risk assessment were used to ascertain if there were high-risk groups of calves that could be identified by age, day-of-the-week born, day-of-the-week died and sex. During the outbreak of neonatal diarrhea on this dairy, female calves were found to have experienced an atypically higher rate of mortality (10.7%) than did males (5.3%). Calves of both sexes died between the ages of 9 and 19 days. In addition, the risk of dying was 11 times greater for calves born on Wednesdays than for those born on Saturdays. These findings formed the basis for recommended changes in management of neonatal calves on the dairy.